Surgical Resection and Adjuvant Radiation Therapy in the Treatment of Skull Base Chordomas

Sanusi, Olabisi; Arnaout, Omar; Rahme, Rudy J.; Horbinski, Craig; Chandler, James P.

doi:10.1016/j.wneu.2018.02.127

Cited by 32 publications

(20 citation statements)

References 68 publications

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“…Lately, Yagiz Yolcu et al's found that compared with GTR alone, GTR plus RT did not offer any signi cant survival bene t for patients with sacral or spinal chordomas, at the price of higher complications rate [33]. However, our result is consistent with a recent nding that pre-recurrence RT in GTR group will prolong PFS [22].…”

Section: Rt After Gtrsupporting

confidence: 88%

“…In addition, the PFS in the late-RT group was shortest in the present series (data not shown); however, the CSS was still longer than that of the patients who had no RT. Similarly, Olabisi Sanusi et al found that a second dose of RT at any point either as sole treatment or as adjuvant treatment for recurrence showed a statistically signi cant effect on PFS (P = 0.009) [22]. Taken together, these ndings indicate that adjuvant RT is an independent factor for better outcomes [7,34], and the importance of pre-recurrence RT is worth emphasizing.…”

Section: Timing Of Rt and Outcomementioning

confidence: 85%

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Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

bai

Shi

et al. 2021

Preprint

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OBJECTIVE: Skull-base chordoma (SBC) is rare and one of the most challenging diseases to treat. We aimed to assess the optimal timing of adjuvant radiation therapy (RT) and evaluate the factors that influence resection and long-term outcomes.METHODS: In total, 284 patients with 382 surgeries were enrolled in this retrospective study. Postsurgically, 64 patients underwent RT before recurrence (pre-recurrence RT), and 47 patients underwent RT after recurrence. During the first attempt to achieve gross-total resection (GTR), when the entire tumor was resected, 268 patients were treated with an endoscopic midline approach, and 16 patients were treated with microscopic lateral approaches. Factors associated with the success of GTR were identified using c2 and logistic regression analyses. Risk factors associated with chordoma-specific survival (CSS) and progression-free survival (PFS) were evaluated with the Cox proportional hazards model.RESULTS: In total, 74.6% of tumors were marginally resected [GTR (40.1%); near-total resection (34.5%)]. History of surgery, large tumor volumes and tumor locations in the lower clivus were associated with a lower GTR rate. The mean follow-up period was 43.9 months. At last follow-up, 181 (63.7%) patients were alive. RT history, histologic subtype (dedifferentiated and sarcomatoid), non-GTR, no postsurgical RT, and the presence of metastasis were associated with poorer CSS. Patients with pre-recurrence RT had the longest PFS and CSS, while patients without postsurgical RT had the worst outcome.CONCLUSION: GTR is the goal of initial surgical treatment. Pre-recurrence RT would improve outcome regardless of GTR.

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Section: Rt After Gtrsupporting

confidence: 88%

Section: Timing Of Rt and Outcomementioning

confidence: 85%

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

bai

Shi

et al. 2021

Preprint

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“…However, the complete surgical resection of aggressive chordomas remains formidable due to the specific location. Adjuvant radiation therapy has been proved to provide benefits in the treatment of skull-base chordomas, whereas chemotherapy has limited efficacy on most chordomas [5,[7], [8], [9]].…”

Section: Introductionmentioning

confidence: 99%

Application of nomograms to predict overall and cancer-specific survival in patients with chordoma

Zheng

Huang

Guan

et al. 2019

Journal of Bone Oncology

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HighlightsAge of diagnosis, primary site, histology, tumor stage, use of surgery and tumor size were identified as independent prognostic factors for both overall and cancer-specific survival of chordoma patients.The optimal age cutoff values of chordoma patients were 38, 54 and 66 years.The optimal cutoff values of chordoma tumor size were identified as 2.9 and 10.0 cm.The nomogram constructed in present study can serve as an effective and convenient evaluation tool to help surgeons to perform personalized survival evaluation and mortality risk identification in chordoma patients.

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“…Evaluating the tumor anatomy is fundamental. Given the relationship to vital structures, total resection is sometimes not technically feasible, or surgical risks may outweigh the benefits [8,9]. For instance, in sellar-based neoplasms, tumors that extend laterally beyond the cavernous sinus, superiorly through the plane of the hypothalamus and floor of the third ventricle, and/or those with retrosellar extension must be critically assessed given associations with increased morbidity [10].…”

Section: Defining Goals Of Surgery and Informed Consentmentioning

confidence: 99%

Perioperative Considerations in Endoscopic Skull Base Surgery

Hussaini

Clark

DeKlotz

2020

Curr Otorhinolaryngol Rep

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Purpose of the Review Present an overview of perioperative considerations specific to endoscopic skull base surgery necessary to maximize successful outcomes. Recent Findings The majority of perioperative considerations for endoscopic skull base surgery lack strong supporting evidence and frequently have varied use or implementation amongst institutions. A notable exception comes from a recent randomized controlled trial demonstrating the benefit of lumbar drainage in high-risk cerebrospinal fluid leaks. Summary Skull base surgeons must consider a multitude of perioperative factors. While many components of perioperative management are extrapolated from related fields such as endoscopic sinus surgery or open cranial base surgery, additional highquality studies are needed to delineate best practices specific to endoscopic skull base surgery.

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Surgical Resection and Adjuvant Radiation Therapy in the Treatment of Skull Base Chordomas

Cited by 32 publications

References 68 publications

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

Long Follow-up Surgical Results in 284 Cases of Clival Chordomas: The Risk Factors for Outcome and Tumor Recurrence

Application of nomograms to predict overall and cancer-specific survival in patients with chordoma

Perioperative Considerations in Endoscopic Skull Base Surgery

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